NEW STUDY

Soluble urokinase receptor and mortality in kidney transplant recipients

A recent study from Heidelberg University Hospital investigated the value of suPAR for the prediction of cardiovascular events and cardiovascular mortality in recipients of kidney transplants. The study analyzed the association between suPAR measured before or at year 1 after transplantation and outcomes in a total of 1,023 kidney transplant recipients.

Conclusion

A high suPAR level prior to and at 1 year after kidney transplantation was associated with an increased risk of patient death independent of kidney function, predominantly from cardiovascular cause.

Methods

Serum suPAR levels in a total of 1,023 kidney transplant recipients either before (cohort 1, n = 474) or at year 1 after transplantation (cohort 2, n = 549) were measured. The association of suPAR levels and all-cause and cardiovascular mortality was evaluated by multivariable Cox regression analysis.

Results

The highest suPAR tertile compared to the two lower tertiles had a significantly higher risk of all-cause mortality in both cohorts separately (cohort 1: hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.20–3.08, p = 0.007; cohort 2: HR = 2.78, 95% CI 1.51–5.13, p = 0.001) and combined (n = 1,023, combined HR = 2.14, 95% CI 1.48–3.08, p < 0.001). The association remained significant in the subgroup of patients with normal kidney function (cohort 2: HR = 5.40, 95% CI 1.42–20.5, p = 0.013). The increased mortality risk in patients with high suPAR levels was attributable mainly to an increased rate of cardiovascular death (n = 1,023, HR = 4.24, 95% CI 1.81–9.96, p < 0.001).